Problems Showering With Fibromyalgia and ME/CFS

A morning shower seems like a basic, harmless thing to most people. After all, it helps you start the day invigorated and refreshed, right?

Um, no, not so much for some of us.

You may have thought it was just you who had this issue but rest assured that it isn't. A shower can pose major problems for those of us with fibromyalgia or chronic fatigue syndrome (ME/CFS).

Why is that? Because several of our symptoms can combine to make us go straight from the shower and back to bed for the rest of the day.

How's that possible?

Especially for those with ME/CFS, even small amounts of exertion can be too much. That's due to a symptom called post-exertional malaise, which is a defining characteristic of this disease. People with fibromyalgia don't have post-exertional malaise, but some of us do have a similar type of exercise intolerance.

A shower takes more energy than we tend to recognize. You're standing the whole time. You do a fair amount of bending, stretching and reaching while vigorously lathering up your head and body.
When you consider that we often have to start a new "exercise" routine with two repetitions of a simple movement, like a yoga pose, you can see how showering may just be too much work for us.

The hot water of a shower can be relaxing, which is great when it comes to tight muscles and connective tissues. However, for those of us who deal with profound fatigue, it's probably not the best thing for us early in the day, when we're still fighting to wake up.

Both of these conditions can overlap with sleep disorders, including insomnia, sleep apnea, and restless legs syndrome. They also both involve unrefreshing sleep. That can leave us extremely tired during the day. If you need to be up and functional, the last thing you need is to relax.

While the hot water may feel good, it can also get our temperature sensitivity going and throw off homeostasis. When we get heated up like that, it's a lot of work to cool us back down to normal. Some of us get so overheated that we sweat profusely after a shower.

In some cases, temperature sensitivity can lead other symptoms to kick up as well, so it pays to be careful and avoid this symptom.

We're prone to dizziness, thanks to a symptom called orthostatic intolerance. Basically, that means we get dizzy upon standing up. It's caused by an abnormal blood-pressure drop.

The heat of the shower combined with the motions of washing (bending down to wash your legs, for instance) can have your body working overtime to keep your sense of balance. Dizzy spells in a hot shower? Very scary, especially when you consider where you'll land if you fall!

The causes of dizziness in fibromyalgia are different from those that cause it in ME/CFS, but the end result is the same.

Especially in fibromyalgia, the pressure of water hitting your skin can get your nerves riled up. For some, it hurts while they're under the spray. In others, it might not hurt during the shower, but the stimulation on their over-reactive nerves could get their bodies sending erroneous pain signals and making them hurt all over.

This phenomenon is called allodynia, which is pain caused by something that wouldn't normally hurt. There's a thermal form of allodynia that could make the heat of a shower even harder to tolerate. Allodynia is almost universal in fibromyalgia and some people with ME/CFS experience it, as well.

The most obvious way to avoid some of these problems is to take a bath. That's a better option when you're talking about dizziness, exertion, and heightened nerve response. And if hot water has a negative impact on you, you can always opt for cooler water.

A bath also tends to steam up the bathroom less, so you may have an easier time cooling off when you get out.

If even a bath is too much exertion for you, or if it's not an option (say, for someone who doesn't have a bathtub), you might want to keep cleansing wipes and dry shampoo on hand so you can freshen yourself up. Facial cleansing wipes or, for those with fragrance sensitivities, unscented baby wipes could be good options.

A shower stool might also be helpful. Sitting down means you'll be doing less bending and stretching and could prevent dizziness while conserving energy.

For those who get too relaxed in a bath or shower, it might be better to take it at night instead of in the morning. It might help you get to sleep, which is always a good thing.